Diabetes Flash Flashcards

1
Q

Blood glucose levels to diagnose T2D.

A

> 7 mmol/L FPG. >11.1 OGT. >11.1 casual PG w/ symptoms. (polydipsia, uria, phagia)

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2
Q

Drugs that cause dyslgycemias (5)

A

Atypical Antipsychotics, thiazides/loop diuretics, Beta blockers, steroids, HIV protease inhibitors.

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3
Q

Long acting insulins (4)

A

Insulin NPH (humulin N, novolin NPH). Insulin detemir (levemir), insulin glargine (lantus)

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4
Q

Short acting insulins (4)

A

Humulin R, Novolin Toronto, Insulin aspart (novorapid), insulin glulisine (apidra), insulin lispro (humalog)

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5
Q

How to empirically start T1D on insulin, or switch T2D to insulin.

A

0.5 units/kg insulin. Split 40% (long acting HS) 60% (short acting split TiD with meals)

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6
Q

How to add insulin to T2DM regimen

A

0.1-0.2 units/kg HS

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7
Q

Mild Hypoglycemia occurs at what level, and what symptoms.

A

< 4.0 mmol/L Irritability, sweating, tremors, nausea, weakness.

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8
Q

Severe hypoglycemia symptoms occur at what level and what symptoms.

A

< 2.8 mmol. Confusion, disorientation, coma.

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9
Q

How to treat hypoglycemia, how much does this increase BG.

A

15g of CHO. Ie. 6 life savers, 1 cup of milk, 3/4 up OJ or soda.

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10
Q

Treatment of T2D: what A1C do we start drug therapy immediately? Alternatively? How long to achieve new A1C targets?

A

> 9% - start 2 agents. <9% try exercise x 3months. Try to achieve target in 9-12months.

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11
Q

The target FPG for T2D, the target post prandial PG. Target A1C. Target BP.

A

4-7mmol/L. 5-10 mmol/L. 7%. 130/80.

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12
Q

Which insulins can you NOT mix.

A

Lantus (glargine). Levemir (detemir)

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13
Q

T2D drug of choice in pregnancy. Alternative (2)

A

Insulin (SWITCH to this in most cases from oral agents. If unable to use insulin: Glyburide. Metformin.

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14
Q

Insulins which are cloudy.

A

Insulin NPHs.

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15
Q

The only sulfonylurea indicated in pregnancy.

A

Glyburide

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16
Q

Sulfonylureas which are cleared renally (2)

A

Glyburide, Chlorpropamide

17
Q

Adverse effects of sulfonyl ureas.

A

Hypoglycemia. Weight gain. (sulfa skin rash?). Interacts with salicylates, MAOis, Azoles, (inhibit metabolism) to increase risk of hypoglycemia.

18
Q

Meglitinide drugs (brand/generic), dosage.

A

Repaglinide, Gluconorm. Nateglinide - Starlix. Take before meals, allows flexibility, because if skip a meal, can skip a dose (unlike gliclazide MR - where skipping meals is bad.)

19
Q

Meglitinides are cleared by.

A

Cyp 3A4 metabolism (not renally cleared)

20
Q

Acarbose Adverse effects.(2)
Contraindicated in. (1)

A

GI intolerance, (flatulence, diarrea, cramps) Liver failure
Inflammatory bowel disease.

21
Q

Oral Antihyperglycemic drugs that are weight neutral.

A

Acarbose, Metformin.

22
Q

Oral Antihyperglycemic drugs that are weight Negative

A

Liraglutide

23
Q

Oral Antihyperglycemic drugs that are weight Positive

A

Sulfonylureas, TZDs, meglitinides,

24
Q

DPP4 inhibitor drugs. Brand/generic. Adverse effects (1).

A

Januvia (sitagliptin), Onglyzza (saxagliptin), Nasopharyngitis (sore throat).

25
Q

Metabolism of DPP 4 inhibs (2)

A

Both renally eliminated. Sitagliptin no cyp interactions. Saxagliptin - Cyp3A4 interactions (sax gets around)

26
Q

TZD drugs (2) and adverse effects (2)

A

Rosiglitazone (avandia), pioglitazone (actos).
Fluid retention (edema, CHF).
Increased Fractures

27
Q

Oral antihyperglycemic drugs which are renally eliminated. (5)
Those which are contraindicated in acute renal failure.(3)

A

Glyburide, Chlorpropamide, sitagliptin, saxagliptin, metformin.
Metformin, glyburide, chlorpropamide.

28
Q

Adverse effects of GLP agonist.
Contraindicated in. (2)

A

Liraglutide (victoza). Nausea/ vomiting/Diarrhea. Nasopharyngitis.
Thyroid cancer. Pregnancy.